Active NPI
Donnetta House, APN
- Psychiatric/Mental Health Nurse Practitioner
- Granite City, IL
National Provider Identifier
1538939145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 209.035986
- Practice address
- 50 Northgate Industrial Dr
Granite City, IL 62040-6805 - Phone
- (618) 877-4420
- NPI assigned
- Jan 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209.035986 | IL | Primary |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 2016025238 | MO |
Addresses
Primary practice location
50 Northgate Industrial Dr
Granite City, IL 62040-6805
Mailing address
1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone (888) 924-3786
Other practice location 1
1150 Graham Rd
Florissant, MO 63031-8077
Phone (314) 206-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2016025238 | Other | MO | RN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016025238 | MO | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1538939145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1003 MARTIN LUTHER KING DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617011429",
"telephone_number": "888-924-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 NORTHGATE INDUSTRIAL DR",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620406805",
"telephone_number": "618-877-4420"
}
],
"practiceLocations": [
{
"address_1": "1150 Graham Rd",
"address_purpose": "LOCATION",
"city": "Florissant",
"state": "MO",
"postal_code": "630318077",
"country_code": "US",
"telephone_number": "314-206-3900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOUSE",
"first_name": "DONNETTA",
"name_prefix": "Ms.",
"credential": "APN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-04",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "209.035986",
"primary": true
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "MO",
"license": "2016025238",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "2016025238",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Granite City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.